LABKING

Our ER wants to give the Rhogam just based on the Rh result. and the reason is the same as above, many patients want to get instant reassurance and get on the way. So what is the hospital's transfusion service's fiduciary duty when the Dr wants to give Rhig and let the patient go. Is the type and screen necessary. Does the patients gestation come into effect. Like less than 20 weeks, 13 weeks, etc. What is the ER physicians duty as to instruction to the patient in regards to prenatal care and the event of Rh-sensitization and positive clinical significant antibody identification. I work in a large Texas hospital system with ER and L&D. we also would like to just "give and go" the Rhig to L&D antenatal outpatients with DR office T&S results. Thank you for any comments.

lets get it done

Congratulations

If safety is the big issue, then keeping accurate accounts of mislabeling would be helpful. Maintaining a strict enforcement of the drawing procedure. Have a 2nd verifier at the time of the draw recorded on the collection record. A 2nd specimen drawn by a different person and typed by a second tech. Stress accountability and education and enforce policy. Any deviation from procedure needs to be with the Pathologist permission and documented. Do not allow multiple tasks in the BB during the processing and testing of BB specimens.

Blood bank bascis are not really established anywhere, it is something that seems to be handed down from blood banker to blood banker. Its great to see these baxic process somewhere to reinforce basic blood banking that I have found key to gain trust and simplicity in avoiding error.

A collection record paper for recording double checks at the bedside and double checks of the relableing in the lab should exceed the FDA expectations. Have a place for initials for each specific check, name, number, DOB, etc . And it would be good to train the checkers to initial after each check, like check the name, initial, check the number, initial, check the DOB, initial. You really will "get-it" once you try it. We fear that distractions will only increase as more automation and computer upgrades evolve. Onetwomanytesttubes:eek:

Thanks I think you misunderstood the thread. We are looking to make it more difficult to issue rh positive rbcs to rh negative patients in the computer. Although this would be quite an obvious thing not to do, the Horizon Safetrace allows it with only a warning that looks similar to the warning of giving rh negative blood to an rh positive patient, which may, in a rush or hurried situation, be a problem.

Hi Safetrace users Does anyone know if it is possible to have Safetrace make it more difficult to issue Rh positive RBCs to Rh negative patients. Currently, with our version, the only thing we get is a warning box, not a mandatory over-ride. We would like to see an override at the Supervisor or Pathogist level. The slip also says this substitution is Compatable, which is not quite accurate, since permission is necessary to give Rh positive to Rh negative patients. All the other safeguards have given us a false sense of security. Anything Can Happen.

We currently do weak D testing on all rh negative females age 55 or less. and cord blood rh negatives born to rh negative moms Since we do all the OB testing by gel, it looks like it would be quite advantageous to drop the weak D on the OB mothers, If we pursue this, do we need to validate or prove that for CAP, FDA, or any other agency that watches over a Transfusion Service. a time saver vs quality blood banking meow

high titer low avidity proved by serial titer showing 3-4 reactions at the same strength in neighboring titers

is there a list or source of information to confirm the standard of practice for 2 specimens when there is no blood type history, is there any information concerning retyping versus immediate spin xmatch when there is no blood type history

after we changed to a new system, I can tell you to do as much research as you possible can. and what is very important is how you implement your new system. much time may be needed for learning and validating many people have trouble using a mouse or browsers with drop down menus

someone had a reply about not using a tx slip from the BB that is amazing, we would like to know more about that, who thought of it, how was it implemented, validated, etc This appears to be a big time and paper saver. what systems are involved

try other methods , other reagents, and storage of reagents may make a difference, think out of the box like gel igg cards work better stored at room temp etc otherwise, we do what Cathy does, Igg xmatch, gives us peace of mind

Ortho is bad about that bad

:(thats horrible, I would not want any extensive surgery there, Especially any kind of L&D

thank you, this really fits and expands our situation, we want to avoid time consuming elutions and other techniques that are best done by dedicated blood bankers. we rotate a number of techs thru our blood bank, it would seem difficult for all of them to acquire the experience to perform the difficult AB-ID's. and space was another concern. Is it necessary to do both IG and poly DAT's for panels, and is it best to do the panels on the automated analyzer for BB by gel or use manual gel [should save reagent, I understand the prime uses a lot of reagent] LK

I have seen FFP thawing upon shift change and no one knew when the units began thawing. Since the units were totally warm and there was no indication of when the units began thawing, I decided to waste the units. We have no written guidelines, so we assume the 30 minute rule after the completion of the thaw. I have also been informed that FFP sent to OR in an ice chest is not eligible for re-issue because it needs to be refrigerated for 8 hours before the hemotemp can be applied. Does anyone have information that would shine more light on FFP room temp limits and re-issue.

Does anyone have a cost analysis of antibody ID, reagent cost, time cost and amount of refrigerator space, necessary equipment, cell washer, limited ID and full service, etc We are looking into doing our own AB ids, currently we send them out to another hospital which increases our TAT

Does anyone have a cost analysis of antibody ID, reagent cost, time cost and amount of refrigerator space, necessary equipment, cell washer, limited ID and full service, etc We are looking into doing our own AB ids, currently we send them out to another hospital which increases our TAT